Aesthetic Plastic Surgery最新文献

{"title":"\"Dou-gong\" Technique: A Novel Biomechanical Approach to Injection Rhinoplasty Based on Nasal Ligament Anatomy.","authors":"Chenzhe Sun, Mengying Jin, Yonghuan Zhen, Jingtao Yuan, Yang An","doi":"10.1007/s00266-026-06359-0","DOIUrl":"https://doi.org/10.1007/s00266-026-06359-0","url":null,"abstract":"<p><strong>Background: </strong>Traditional injection rhinoplasty often prioritizes superficial volume augmentation, which can lead to unnatural nasal contours, transient aesthetic effects, and various complications.</p><p><strong>Objective: </strong>This study introduces the \"Dou-gong\" technique, a novel biomechanical approach to injection rhinoplasty inspired by ancient Chinese architecture, and evaluates its clinical efficacy in enhancing nasal contour through nasal ligament support.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 100 patients who underwent the \"Dou-gong\" injection procedure between January and December 2025. The technique targets five precise anatomical zones: the tip, supratip, dorsum, radix, and columella base. Hyaluronic acid was delivered above the periosteum or perichondrium using a 27-G sharp needle to reinforce the structural support of the nasal ligaments. Clinical outcomes were assessed using the Rhinoplasty Outcome Evaluation (ROE) questionnaire and visual analogue scale (VAS) for pain, swelling, and overall satisfaction. Objective outcomes were presented by photogrammetric analysis through 4 nasal landmark parameters.</p><p><strong>Results: </strong>All 100 patients demonstrated improvements in nasal aesthetics. VAS scores indicated high levels of patient satisfaction, accompanied by minimal procedural pain and postoperative swelling. No severe complications, such as vascular occlusion or material displacement, were observed during the follow-up period.</p><p><strong>Conclusion: </strong>The \"Dou-gong\" technique provides a preliminary, feasible alternative in non-surgical rhinoplasty by shifting the clinical focus from mere volume accumulation to biomechanical ligament reinforcement. Future prospective, randomized controlled investigations are required to evaluate efficacy and benchmark performance against conventional injection modalities.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant-Compensable Ptosis: A Retrospective Cohort Study Comparing Polyurethane Breast Augmentation Alone Versus Augmentation-mastopexy in Patients with Mild Ptosis.","authors":"Sergio Burciaga Soto, Norman Alejandro Rendón Mejía","doi":"10.1007/s00266-026-06344-7","DOIUrl":"https://doi.org/10.1007/s00266-026-06344-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with mild breast ptosis who decline mastopexy pose a clinical challenge. Polyurethane-coated implants possess tissue-adherence properties that may compensate for mild ptosis, but no study has systematically evaluated outcomes in this specific subgroup using defined selection criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the clinical outcomes of breast augmentation with polyurethane-coated implants without mastopexy in patients with mild ptosis meeting Implant-Compensable Ptosis (ICP) classification criteria, compared to augmentation-mastopexy and augmentation in non-ptotic controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective three-arm cohort study of 90 consecutive patients (180 breasts) who underwent breast augmentation with polyurethane-coated implants: Group A (ICP, mild ptosis without mastopexy, n = 30), Group B (control, no ptosis, n = 30), and Group C (augmentation-mastopexy, n = 30).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Primary outcome: &lt;/strong&gt;BREAST-Q Satisfaction with Breasts at 24 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Secondary outcomes: &lt;/strong&gt;compensation failure rate (composite of secondary mastopexy, NAC descent &gt; 2 cm, or BREAST-Q decline ≥ 15 points), operative time, capsular contracture, complications, and patient satisfaction. Non-inferiority was assessed against a 5-point margin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 24 months, mean BREAST-Q Satisfaction with Breasts was 75.6 ± 9.5 (Group A), 79.3 ± 11.2 (Group B), and 77.4 ± 9.8 (Group C). The difference between Groups A and C was - 1.8 points (95% CI: - 7.1 to + 3.5; p = 0.494), consistent with non-inferior performance, although formal non-inferiority was not established due to limited statistical power (65% vs. planned 80%). Compensation success rate was 90.3% at 24 months (3 failures: 2 secondary mastopexy, 1 anatomical). Mean operative time was 36 min shorter in Group A versus C (66 vs. 102 min; p &lt; 0.001). No capsular contracture Baker ≥ III occurred in any group. Mean NAC descent at 24 months was 0.82 ± 0.55 cm in Group A, significantly greater than Groups B and C (p &lt; 0.001) but below the 2.0 cm failure threshold.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In patients with mild ptosis meeting ICP criteria, breast augmentation with polyurethane implants alone achieves BREAST-Q satisfaction scores suggestive of non-inferiority to augmentation-mastopexy at 24 months, with a 90% compensation success rate and 35% shorter operative time. Implant volume (≤ 350 cc) emerges as a potential additional criterion. The ICP classification provides the first structured framework for patient selection, counseling, and outcome monitoring in this common clinical scenario. Prospective validation is warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence iii: &lt;/strong&gt;This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.sprin","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clinical Algorithm for Gynecomastia: From Diagnosis to Surgical Management.","authors":"Jung-Eun Moon, Seok Gi Kim, Jongmoo Park, Yun-Sok Ha, Joon Suk Moon, Byeongju Kang, Jeeyeon Lee, Ho Yong Park, Jeong Yeop Ryu, Kang Young Choi, Jung Dug Yang, Ho Yun Chung, Joon Seok Lee","doi":"10.1007/s00266-026-06379-w","DOIUrl":"https://doi.org/10.1007/s00266-026-06379-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gynecomastia is a heterogeneous disorder spanning the full pediatric-to-adult age range; however, comprehensive single-institution analyses that integrate endocrine, comorbid, drug-related, and surgical perspectives within one framework remain limited. We characterized the demographic and etiologic landscape of gynecomastia in a large retrospective cohort, propose a practical diagnostic algorithm derived from these patterns, and summarize the institutional experience with surgical management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed all male patients with an electronic-medical-record diagnosis of gynecomastia at two tertiary academic hospitals between January 2011 and March 2026. True gynecomastia was confirmed clinically and, where indicated, by ultrasonography, mammography, or magnetic resonance imaging. Patients were categorized by primary etiology (physiologic, drug- or substance-induced, endocrine, pathologic systemic, or idiopathic) using a standardized diagnostic workflow, and surgical candidates were graded according to the Simon classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 754 patients screened, 562 met criteria for true gynecomastia (pediatric ≤ 17 years, 30 [5.3%]; adult ≥18 years, 532 [94.7%]; mean age 58.7 ± 19.8 years; median 64, range 0-95). Bilateral disease accounted for 75.9% of patients with documented laterality. Idiopathic disease was the largest category (362; 64.4%), followed by drug- or substance-induced disease (135; 24.0%), pathologic systemic disease (43; 7.7%; predominantly chronic liver and kidney disease), endocrine disorders (13; 2.3%), and overt physiologic gynecomastia (6; 1.1%). Spironolactone (71 patients; 52.6% of drug-induced cases) and antiandrogen / androgen-deprivation therapy agents (28; 20.7%) jointly accounted for nearly three quarters of drug-induced disease. Etiologic distribution differed markedly by age: physiologic and idiopathic causes predominated in adolescents, whereas drug-induced disease rose sharply from the fifth decade onward and accounted for ≈26-29% of cases in patients aged 50-80 years. Forty-three patients (7.7%) underwent surgical correction (mean age 33.7 ± 18.9 years), most commonly for long-standing persistent disease or cosmetic and psychosocial indications; surgical conversion was substantially higher in idiopathic (9.3%) than in drug-induced (2.2%) or systemic pathologic disease (2.3%). Histopathology confirmed benign glandular hyperplasia in all 43 surgical specimens; no occult male breast carcinoma or other malignant tissue was identified (0 of 43), and patients with male breast carcinoma at initial presentation were excluded a priori.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Across a 15-year cohort, idiopathic and drug-induced disease (chiefly spironolactone and antiandrogen-class agents) accounted for nearly 90% of adult cases. A stepwise algorithm based on examination, medication review, and selective endocrine and radiolog","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Timing Before Age 3 for Congenital Ptosis: Enhancing Refractive Parameters Recovery in Children.","authors":"Shuqin Zhuan, Qiaoran Qi, Jiaying Zhang, Jin Li","doi":"10.1007/s00266-026-06297-x","DOIUrl":"https://doi.org/10.1007/s00266-026-06297-x","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to evaluate the impact of congenital ptosis on visual development and observe postoperative refractive parameters recovery patterns between two distinct age groups: children under 3 years and preschool-aged children (3-6 years).</p><p><strong>Methods: </strong>A cohort study was conducted among 77 patients aged 1 to 6 years diagnosed with severe unilateral congenital simple ptosis at our hospital. Key data points included demographic data, marginal reflex distance 1 (MRD1), refractive status, and best-corrected visual acuity (BCVA). Preoperative refractive data and ocular examination results were compared with corresponding postoperative data.</p><p><strong>Results: </strong>The prevalence of pathological anisometropia preoperatively was 26.9% for toddlers and 20% for preschoolers. There was a significant difference in preoperative cylinder power between the affected and unaffected eyes (P < 0.01). Among patients aged under 3 years, postoperative difference in spherical equivalent (△SE) showed significant improvement compared to preoperative △SE (P < 0.05). Among patients older than 3 years, there was no significant change in △SE or BCVA. Both age groups showed no significant change in cylinder power.</p><p><strong>Conclusion: </strong>Severe unilateral congenital ptosis induces pathological anisometropia and astigmatism while depleting hyperopic reserve in pediatric patients. Early surgical intervention before age 3 years effectively enhances the recovery of refractive parameters. The evidence substantiates the requirement for timely surgical correction during the visual system's critical developmental period.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostatic Net in Facial Aesthetic Surgery: A Systematic Review and Meta-Analysis.","authors":"Enes Agah Kodalak, Lucas Monteiro Delgado, Mert Ersan, Fahriye Büşra Genç, Victoria Zecchin Ferrara, Krishna S Vyas","doi":"10.1007/s00266-026-06335-8","DOIUrl":"https://doi.org/10.1007/s00266-026-06335-8","url":null,"abstract":"<p><strong>Introduction: </strong>Hematoma is the most frequent and consequential complication after rhytidectomy. The hemostatic net (HN)-a temporary transcutaneous lattice anchoring the flap to the SMAS-platysma-aims to eliminate dead space and minimize shear. Earlier reviews were limited by small samples and methodological heterogeneity. This updated systematic review and meta-analysis synthesizes all available evidence to quantify HN safety and efficacy in facial aesthetic surgery.</p><p><strong>Methods: </strong>Following PRISMA 2020 and Cochrane guidelines (PROSPERO CRD420251149130), PubMed, Scopus, and Cochrane Library were searched through September 2025. Comparative and single-arm studies reporting hematoma, necrosis, seroma, or hyperpigmentation were included. Random-effects DerSimonian-Laird models generated pooled odds ratios (OR) and proportions with 95 % confidence intervals (CI).</p><p><strong>Results: </strong>Thirteen studies encompassing 3264 unique patients (2175 HN treated) met inclusion criteria; six were comparative. In cervicofacial rhytidectomy, HN reduced the odds of hematoma by 93% compared with drain-based closure (OR 0.07; 95% CI 0.02-0.24; P < .0001; I² = 25%). No difference in necrosis was observed (OR 0.73; 95% CI 0.20-2.63; P = .63; I² = 0%). Single-arm pooled rates were hematoma 1.09%, seroma 1.66%, necrosis 0.96%, and persistent hyperpigmentation 0.28%; these are descriptive estimates of incidence and do not support comparative inference. Sensitivity analyses confirmed robustness.</p><p><strong>Conclusions: </strong>In cervicofacial rhytidectomy, HN was associated with lower odds of hematoma than drain-based closure, without an increase in skin necrosis. Single-arm analyses provide descriptive estimates of low absolute complication rates, including in gliding brow lift, but do not establish comparative effectiveness outside rhytidectomy. Pigmentary change at suture entry sites is the most frequent visible adverse event and, although usually self-limited, may take up to three months to resolve and warrants explicit preoperative counseling. Evidence derives predominantly from non-randomized studies, and pooled estimates should be interpreted as hypothesis-generating.</p><p><strong>Level of evidence ii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Artificial Intelligence Adoption in Aesthetic Practice: A Cross-Sectional Study.","authors":"Gökhan Öcel, Dilaver Tengilimoğlu, Elif Eşiyok Barut, Mehmet Sönmez","doi":"10.1007/s00266-026-06321-0","DOIUrl":"https://doi.org/10.1007/s00266-026-06321-0","url":null,"abstract":"<p><strong>Background: </strong>The integration of artificial intelligence (AI) into plastic and aesthetic surgery is advancing rapidly, with applications in preoperative image analysis, outcome simulation, and complication prediction. However, the adoption of AI-based systems in clinical practice remains limited, and the psychological and structural determinants of adoption among plastic surgery physicians are not fully understood. This study examines the cognitive, emotional, and structural factors influencing AI adoption intentions within an extended Unified Theory of Acceptance and Use of Technology (UTAUT) framework.</p><p><strong>Methods: </strong>A quantitative cross-sectional survey was conducted among 102 physicians, including specialists, senior residents, and certified cosmetic medicine practitioners. The extended UTAUT model incorporates performance expectancy, effort expectancy, AI anxiety, and perceived barriers as determinants of behavioural intention. Data were analysed using exploratory factor analysis, Pearson's correlation, and multiple linear regression.</p><p><strong>Results: </strong>Performance expectancy (β = 0.431, p < 0.001) and effort expectancy (β = 0.287, p < 0.001) significantly and positively predicted AI adoption intention, together explaining 52% of the variance (R² = 0.52). Conversely, AI anxiety (β = - 0.251, p < 0.001) and perceived barriers (β = - 0.189, p = 0.004) had significant negative effects. Demographic variables, including age and professional experience, showed no statistically significant influence on adoption intention.</p><p><strong>Conclusions: </strong>In plastic and aesthetic surgery, perceived clinical utility and ease of use are the primary drivers of AI adoption, whereas emotional concerns and structural barriers act as significant impediments. Targeted educational programmes, transparent AI systems, and ethically grounded regulatory frameworks are essential for fostering sustainable AI integration into aesthetic surgical practice.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Subcutaneous Mastectomy with Cold-Knife Flap Dissection Through a Single Axillary Incision for Gynaecomastia.","authors":"Jinqiu Xue, Hua Zhu, Qiang Ding","doi":"10.1007/s00266-026-06274-4","DOIUrl":"https://doi.org/10.1007/s00266-026-06274-4","url":null,"abstract":"<p><strong>Background: </strong>Gynaecomastia (GNY) is the most common benign proliferation of glandular breast tissues in males and is frequently associated with psychosocial distress and aesthetic concerns. Traditional open surgical approaches are associated with visible scarring and prolonged postoperative recovery. Minimally invasive techniques, including liposuction-assisted endoscopic procedures, may still result in visible scars and residual glandular tissue. In this study, we evaluated the safety, efficacy, and aesthetic outcomes of endoscopic subcutaneous mastectomy combined with cold-knife flap dissection through a single axillary incision for the treatment of GNY.</p><p><strong>Methods: </strong>A total of 51 male patients with GNY involving 102 breasts who underwent surgical treatment between August 2023 and October 2024 were enrolled. Patient demographics, operative data, postoperative complications, and satisfaction outcomes were systematically recorded. Four independent observers evaluated preoperative and postoperative photographs using a 1-15 scoring system based on six major aesthetic parameters.</p><p><strong>Results: </strong>Endoscopic subcutaneous mastectomy combined with cold-knife flap dissection through a single axillary incision was successfully completed in all patients. The mean operative time was 46.84 ± 15.04 per side (range 14-87) min. The mean thickness of the resected glandular tissues was 2.80 ± 0.88 (range 1-5) cm. The mean postoperative drainage volume was 48.72 ± 34.74 (range 10-170) mL, and the mean hospital stay was 4.31 ± 1.57 (range 2-8) days. Postoperative complications included hematoma in two breasts, seromas in one breast, and effusion in two breasts, whereas skin redundancy occurred in two patients with bilateral GNY. No patient developed severe pain, infection, nipple-areolar complex necrosis, nipple retraction, or skin flap necrosis. All patients reported satisfaction with postoperative quality of life (100%), and no recurrence was observed during follow-up.</p><p><strong>Conclusions: </strong>Endoscopic subcutaneous mastectomy combined with cold-knife flap dissection through a single axillary incision appears to be a safe and effective approach for GNY, offering minimal invasiveness, rapid postoperative recovery, and favourable aesthetic outcomes. This technique may improve patient satisfaction and may represent a promising treatment option owing to its favourable safety profile and cosmetic outcomes.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capsulectomy Following Breast Implant Removal: Evidence-Based Indications and a Framework for Clinical Decision-Making.","authors":"Tim Brown MChir","doi":"10.1007/s00266-026-06365-2","DOIUrl":"https://doi.org/10.1007/s00266-026-06365-2","url":null,"abstract":"<p><p>The question of when capsulectomy is genuinely indicated at the time of breast implant removal has important implications for clinical practice, surgical risk, and patient counselling. This review defines the evidence-based indications for capsulectomy, evaluates the evidence for each of the additional contexts in which it is commonly proposed, and provides a clinical decision framework to assist surgeons in counselling patients and documenting clinical reasoning. No published study directly compares outcomes of explantation with capsulectomy versus explantation alone; the most rigorous prospective data show that explantation without capsulectomy produces symptom improvement statistically indistinguishable from partial or total capsulectomy. The only pre-registered controlled cohort study (n = 9590) found no difference in BII symptom prevalence between women with and without implants, and silicone particle migration to lymph nodes is not reduced by capsulectomy in controlled analyses. The proposed capsular contaminants (biofilm, fungal elements, and heavy metals) have each been examined in controlled tissue analyses; none differentiates symptomatic from asymptomatic patients. A 2024 European expert consensus recommending capsulectomy for macrotextured implants constitutes Level V consensus from a panel composed exclusively of surgeons who perform the procedure. Capsulectomy carries a higher complication rate than explantation alone, and no published evidence documents harm from leaving a capsule in situ after benign explantation. Four indications are supported by the available evidence: confirmed BIA-ALCL, confirmed capsular malignancy, symptomatic capsular calcification with demonstrable mammographic impairment, and Grade III-IV contracture where capsulotomy is insufficient. A clinical decision framework is provided to facilitate evidence-based practice and structured informed consent. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Preoperative GLP-1 Receptor Agonists and Thromboinflammatory Markers in Patients Undergoing Abdominoplasty: A Prospective Monocentric Study\".","authors":"Mahin Nosratzehi, Shahin Nosratzehi, Mehdi Rostami","doi":"10.1007/s00266-026-06399-6","DOIUrl":"https://doi.org/10.1007/s00266-026-06399-6","url":null,"abstract":"","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Distal U-Shaped Capsule Sparing Technique (DUS-CS) for Revision Breast Augmentation: A Consecutive Clinical Series of 223 Patients.","authors":"Annabelle M Bromba, Marc Daniels, Sonia M Fertsch, Katrin Seidenstücker, Beatrix Munder, Mazen Hagouan, Dirk Janku, Birgit Aufmesser-Freyhardt, Nour Abu Abdallah, Robert J Musmann, Nora Stockhausen, Sogol Rajabpour, Benedetta Vasselli, Laura Wohlthat, Andreas Wolter, Christoph Andree","doi":"10.1007/s00266-026-06351-8","DOIUrl":"https://doi.org/10.1007/s00266-026-06351-8","url":null,"abstract":"<p><strong>Background: </strong>Capsular contracture is a common complication following breast augmentation with silicone implants, which often requires surgical revision, especially in advanced stages. A surgical gold standard for the treatment of capsular contracture is still under discussion. This article presents a novel capsule-sparing method for implant exchange in patients with capsular contracture.</p><p><strong>Methods: </strong>This is a retrospective, descriptive, single-center technical study focusing on the detailed presentation, surgical rationale, and standardized execution of a novel capsule-sparing revision technique. The technique combines a U-shaped selective capsulectomy with the Double-Unit Superomedio-Central (DUS-CS) approach to preserve structurally intact capsule segments, minimize surgical trauma, and maintain implant position during revision surgery. The central and cranial parts of the capsule are removed, while the medial, lateral, and caudal parts are left in place. The newly inserted breast implant is limited and stabilized by the remaining capsule remnants. Possible implant dislocation is reduced, and soft tissue coverage is improved.</p><p><strong>Results: </strong>A total of 223 patients have already undergone surgery using the DUS-CS technique between January 1, 2023, and November 21, 2025. Within the available follow-up period, no recurrence of capsular contracture, symmastia, or bottoming out were observed in the treated cohort.</p><p><strong>Conclusions: </strong>This technique allows effective treatment of capsular contracture while avoiding the morbidity of total capsulectomy. Preliminary clinical experience demonstrates feasibility and safety, particularly in revision cases where maintenance of pocket geometry is essential. Larger studies are required to evaluate long-term outcomes and recurrence rates.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}